RESUMEN
Objective: To determine the incidence of SARS-CoV-2 infection and its association with sociodemographic, clinical, and occupational characteristics in health workers (HCWs) in the COVID-19 risk area. Material(s) and Method(s): Longitudinal analytical study in a cohort of TS from the "Zafiro" area of patients with suspected or confirmed diagnosis of SARS-CoV-2 infection. The identification of positive cases of SARS-CoV-2 was carried out with the RT-PCR test. Result(s): The cohort was made up of 114 SWs, with an average age of 35.3+/-7.4 years, with positions as general practitioner (26.3%), nursing assistant (21.1%) and nurse (19.3%). The incidence rate of SARS-CoV-2 (31.6%) and reinfection (1.8%) during seven months. The factors jointly associated with SARS-CoV-2: cohabitation with people at high risk of contagion (HR=2.406, 95% CI: 1.225, 4.726, p=0.011), the lowest educational level (HR=2.241, 95% C: 1.051, 4.782, p=0.037) and a higher consumption of sleep medications (HR=4.680, 95% CI: 1.328,16.486, p=0.016). Conclusion(s): The contagion rate of SARS-CoV-2 during seven months of the pandemic, in health workers was high (one in three SW) associated with cohabitation with high-risk people, lower educational level and higher consumption of medications for to sleep. A situation of concern in the HCWs was the suspected cases of SARS-CoV-2 reinfection.Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.
RESUMEN
Background. Data are currently limited on the performance of SARS-CoV-2 RNA levels as predictors or surrogate markers for clinical outcomes in outpatients with mild-to-moderate COVID-19. Methods. This exploratory analysis used data from 2205 non-hospitalized adults who enrolled between August 2020 and July 2021 and participated in placebocontrolled evaluations of two monoclonal antibody (mAb) agents (bamlanivimab [n=317] or amubarvimab/romlusevimab [n=837]), and an open-label cohort of bamlanivimab recipients [n=1051] as part of the ACTIV-2/A5401 platform trial. SARS-CoV-2 RNA levels were measured in anterior nasal (AN) swabs and plasma at day 0 (pre-treatment) and AN at day 3. We fit regression models to estimate the association between RNA level or detection and subsequent hospitalization/death within 28 days of enrollment. Results. One-hundred four participants (53/571 [9%] on placebo and 51/ 1634 [3%] on mAb) died or were hospitalized through day 28. Median AN RNA levels were lower at day 3 compared to day 0 in both placebo (2.5 vs 4.0 log10 copies/mL [cp/mL]) and mAb (2.3 vs 4.9) groups. For placebo recipients, higher Day 0 AN RNA was associated with an increasing risk of hospitalization/ death, ranging from 3% to 16% for < 2 and >= 6 log10 cp/mL, respectively. Although only 1% had quantifiable plasma SARS-CoV-2 RNA, there was a similar trend for day 0 plasma RNA: 5% hospitalizations/death for undetectable RNA, 16% for detectable but not quantifiable RNA, and 80% for >= 2 log10 cp/mL. Among 485 placebo recipients with days 0 and 3 ANRNA results, the risk of subsequent hospitalization/death was highest among those with >= 5.0 log10 cp/mL at both days [8/78;10%] and lowest for those with unquantifiable levels at both days [0/124;0%]. Higher AN RNA at day 3 (adjusted for day 0 RNA) was associated with subsequent hospitalization/death among placebo recipients (relative risk (RR): 1.4 per log10 cp/mL;95%CI: 1.0, 2.1), but not mAb recipients (RR: 1.0;95%CI: 0.7, 1.6). Conclusion. These findings suggest that AN and plasma SARS-CoV-2 RNA levels are predictive of hospitalization/death in the natural history setting. However, different associations for mAb and placebo recipients raises concerns for using AN RNA as a surrogate for clinical outcomes in mAb trials. (Table Presented).